Changing MIC Breakpoints: Do Mechanisms Count
Changing MIC Breakpoints: Do Mechanisms Count Changing MIC Breakpoints: Do Mechanisms Count
CLSI Guidance on ESBL Testing • Will Tests for ESBLs and KPCs be needed with the new cephalosporin and carbapenem breakpoints for Enterobacteriaceae? CLSI says No. For patient management, tests for ESBLs and KPCs are not necessary If requested, tests for ESBLs and KPCs may be done for Infection Control purposes 6
New CLSI Guidelines 2010 • This decision was based on evaluation of pharmacokinetics-pharmacodynamics (PK-PD) properties and limited clinical trials • New interpretive criteria (breakpoints) establish for some (but not all) cephalosporins • Using new breakpoints treatment decisions can be based solely on MIC alone • “It’s all about the MIC stupid” 7
- Page 1 and 2: Changing MIC Breakpoints: Do Mechan
- Page 3 and 4: • The major issue is whether the
- Page 5: CLSI Guidelines Staph spp. Table 2
- Page 9 and 10: Clinical Studies • No randomized
- Page 11 and 12: New CLSI Guidelines 2010 • Proble
- Page 13 and 14: MICs in g/ml: SHV-3 producing Citro
- Page 15 and 16: Efficacy of different beta-lactams
- Page 17 and 18: Efficacy of different beta-lactams
- Page 19 and 20: Efficacy of different beta-lactams
- Page 21 and 22: CAP Survey D-C 2007 D-19 C. freundi
- Page 23 and 24: New CLSI Guidelines 2010 • Proble
- Page 25 and 26: MIC Reproducibility • In this imp
- Page 27 and 28: Enterobacteriaceae Revised Breakpoi
- Page 29 and 30: Cephaloporin Breakpoints Following
- Page 31: New CLSI Guidelines 2010 • Proble
- Page 34 and 35: Why labs should continue to perform
- Page 36 and 37: Are the New CLSI Breakpoints the Co
- Page 38 and 39: Something to Think About • Breakp
- Page 40 and 41: Something to Think About • Antibi
- Page 42 and 43: Personalized Antibiotic Report •
- Page 44 and 45: Personalized Antibiotic Report •
- Page 46: Are the New CLSI Breakpoints the Co
New CLSI Guidelines 2010<br />
• This decision was based on evaluation of<br />
pharmacokinetics-pharmacodynamics (PK-PD)<br />
properties and limited clinical trials<br />
• New interpretive criteria (breakpoints) establish<br />
for some (but not all) cephalosporins<br />
• Using new breakpoints treatment decisions can<br />
be based solely on <strong>MIC</strong> alone<br />
• “It’s all about the <strong>MIC</strong> stupid”<br />
7
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